Shane Austin Smith

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

7405 SE 84TH Ave
Portland, OR 97266-5840

Phone

(503) 771-1645

NPI assigned

Nov 11, 2014

Last updated

Nov 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1457757999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12248 SE MARKET ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331235",
            "telephone_number": "503-995-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 SE 84TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972665840",
            "telephone_number": "503-771-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANE",
        "middle_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Montgomery Smith, LMT
• Sean Smith, RN
• Sean Michael Smith
• Sean Stephen Smith, CRM
• Sequoia Smith
• Shane Patrick Smith, M.D.
• Shannon Smith, LPC
• Shannon Lee Smith, PMHNP, MPH
• Sharon Elizabeth Smith, MS
• Sheryl P Smith, RDH

• Adult Companion in Portland, OR
• Providers in Portland, OR by specialty
• Adult Companion in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.